Methods	Randomized, placebo-controlled trial; 2 parallel groups.
	Unit of randomization: individual.
Participants	Dates of data collection: not reported.
	Setting: Central Baptist Hospital, Lexington, Kentucky, US.
	Inclusion criteria: women undergoing primary, non-elective CS (while it appears most women were in labor and/or had ruptured membranes it is unclear whether all patients fulfilled our criteria for non-elective)
	Exclusion: antibiotic use within 7 days, penicillin or cephalosporin allergy
Interventions	Cefamandole 500 mg IV immediately after the cord was clamped, again in the recovery room and two more doses 6 hours apart (N = 43) vs identical-appearing placebo (N = 47)
Outcomes	Infectious morbidity (fever > 100.3°F twice 6 hours apart after first 24 hours); endomy-ometritis (fever, uterine tenderness, and positive culture from endometrium); wound infection, UTI; maternal duration of stay (treatment 5.1 days vs placebo 5.4; not significant, no variance given)
Notes	There was 1 episode of bacteremia in the control group.
	Class of antibiotic: second generation cephalosporin.
	Subgroups:
	type CS unclear; after cord clamping.
Risk of bias
Item	Authors’ judgement	Description
Adequate sequence generation?	Unclear	Randomized. No further information.
Allocation concealment?	Yes	“according to pre-numbered envelopes maintained in the central pharmacy.”
Blinding?	Yes	Described as “double-blind”.
All outcomes		Placebo-controlled: “identical appearing, equal volume solution”
Incomplete outcome data addressed?	Yes	No loss to follow up.
All outcomes		No participant excluded.
		ITT analysis.
Free of selective reporting?	Unclear	Insufficient information to judge.
Free of other bias?	Unclear	The 2 groups were comparable regarding age, race, parity, weight, type of anesthesia, operating time or pre-operative hematocrit. There was insufficient other information which to judge
Overall low risk of bias?	Unclear	Mostly unclear.